<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>Edit Membership Details</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="edit" method=post>
             
             <div class=_50> 
                <p><label for=textarea>Membership No</label>
                    <input type="mshipno" id="mshipno" name="mshipno" value="<?php echo $record['Member']['mshipno'];?>"/>
                    <input type="hidden" id="record_id" name="record_id" value="<?php echo $record['Member']['id'];?>"/>
                </p> 
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Title</label>
                    <input id="toh" name="toh" class="" type="text" value="<?php echo $record['Member']['toh'];?>"/></p>
            </div> 

            <div class=_50> 
                <p><label for=textarea>Name</label>
                    <input id="mname" name="mname" class="" type="text" value="<?php echo $record['Member']['mname'];?>"/></p>
            </div> 
            
            <div class=_50>
                  <p><label for=select>Gender</label> 
                    <select name="gender" id="gender" class="required" type="text"> 
                        <option value="<?php echo $record['Member']['gender'];?>"></option>
                        <option value="Please Select Gender">Please Select Gender</option> 
                        <option value="Male">Male</option> 
                        <option value="Female">Female</option>
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>Membership Type By</label> 
                    <select name="mshiptype" id="mshiptype" class="required" type="text"> 
                        <option value="<?php echo $record['Member']['mshiptype'];?>"></option>
                        <option value="Please Select Membership Type">Select Membership Type</option> 
                        <option value="Baptism">Baptism</option>
                        <option value="Transfer In">Transfer In</option> 
                        <option value="Profession of Faith">Profession of Faith</option>
                    </select>
                </p>
            </div> 

            <div class=_50>
                  <p><label for=select>Status</label> 
                    <select name="status" id="status" class="required" type="text"> 
                        <option value="<?php echo $record['Member']['status'];?>"></option>
                        <option value="Please Select MembershipnStatus">Select Membership Status</option> 
                        <option value="Active">Active</option>
                        <option value="Transfered Out">Transfered Out</option> 
                        <option value="Censured">Censured</option>
                        <option value="Missing">Missing</option>
                        <option value="Passed On">Passed On</option>
                        <option value="Disfellowshipped">Disfellowshipped</option>
                    </select>
                </p>
            </div> 

            <div class=_50> 
                <p> <label for=datepicker>Membership Date</label>
                   <input  id="mshipdate" name="mshipdate" class=" "  value="<?php echo $record['Member']['mshipdate'];?>"/>
            </div>
 
            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 
                <ul class=actions-right> 
                    <li><input type=submit id="Save-Incoming Correspondence" class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 